Friday, February 3, 2017

1881: Recipes for inhaled medicine

There were many inhalers available during the second half of the 19th century that allowed patients with various respiratory disorders to inhale medicine.  Which inhaler used, and which medicine used, depended on the desires of the physician and patient.

The recipe for making the medicine was usually found in a pharmacopoeia.  The ingredients were usually purchased by the patient and prepared using the recipe, which was usually given to the patient by the physician.

While the physician would recommend a dose and frequency, he would probably give the patient some leeway to titrate them for desired effect. Once a patient received relief with minimal side effects from a particular medicine, he probably gained confidence in adjusting both the dose and frequency.  In this way, many patients became their own physicians.

Dr. Morell Mackenzie recommended steam powered inhalers, particularly the Eclectic Inhaler.  This was a small inhaler that allowed the patient to easily inhale steam in any position.

A pharmacopoeia he edited contained many recipes inhaled medications for breathing disorders.  Usually a pint of boiling water was poured into a steam inhaler with about a teaspoon of the medicine.  However, in some instances other means of inhaling the medicine were indicated (as in recipe #5 below).

Here is a small sample of some recipes for inhaled medicine that were found in the 4th edition "The Pharmacopoeia of the Hospital for Diseases of the Throat and Chest" published in 1881.

1.  Vapor Amyl Mitritis:
Nitrate of Amyl...8 minims
Reflected Spirit... to 1 ounce
A teaspoon in a pint of water at 100° F for each inhalation
Use.—Anti-spasmodic. Very valuable in some cases of asthma and spasm of the glottis.
Note.—This remedy has also been recommended as a dry Inhalation, but in this form it occasionally produces giddiness, &c.
2.  Vapor Ammonise:  Mix 4 drachms of a solution of Ammonia (exact dose given) and mix with 4 drachms of water.  
Mix. A teaspoonful in a pint of water at 80° F. for each Inhalation.
Use.—Stimulant; useful in chronic laryngitis and functional aphonia. This Inhalation may be advantageously employed in combination with any of the volatile oils, or with Camphor or Thymol. In such case Prepared Kaolin is to be used for keeping the oils in suspension in place of Light Carbonate of Magnesia.
Note.—The strong salts of Ammonia, employed as smelling-salts, are very useful in cases of obstinate sneezing, as in hay-fever, influenza, &c. The patient should be directed to smell the salts directly a disposition to sneeze is felt.
3.  Vapor Acidi Hydrocyanici:  
Dilute Hydrocyanic acid (dose given) and mix 1 drachm of it to 1 drachm of water.  
A teaspoon in a pint of water at 80° F for each inhalation
Use.—Sedative. Very useful in the cough of laryngeal phthisis, and in some spasmotic affections.
4.  Vapor Etheris:
Mix 1/2 ounce of ether with 1/2 ounce of Rectified Spirit.
A teaspoon in a pint of water at 80° F for each inhalation.
Use.—Sedative and antispasmotic
5.  Vapor Ethyl Iodidi:
Iodide of Ethyl, a sufficient quantity
Five to ten drops on a piece of lint or handkerchief for Inhalation.
 Use.—For cases of bronchial asthma
There were many other medicinal recipes, although I think this will suffice for our purposes.   

  1. Mackenzie, Morell, editor, "The Pharmacopoeia of the Hospital for Diseases of the Throat and Chest," 4th edition, 1881, Philadelphia, Plesley Blakiston
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